全膀胱切除去带乙状结肠原位新膀胱术（附31例报告）  

Radical Cystectomy and Orthotopic Neobladder Substitution With Taenia Myectomy Sigmoid

作　　者：谢庆祥[1] 林吓聪[1] 谢智明[1] 胡志许 伟杰[1] 

机构地区：[1]解放军第175医院(厦门大学附属东南医院)泌尿外科,福建漳州363000

出　　处：《医学临床研究》2013年第12期2374-2375,2378,共3页Journal of Clinical Research

摘　　要：【目的】探讨全膀胱切除术后，去带乙状结肠原位新膀胱术的可行性和效果。【方法】回顾性分析3l例膀胱癌患者行根治性全膀胱切除去带乙状结肠原位新膀胱术的临床资料及随访的结果。【结果131例患者均无围手术期死亡，术后早期15例出现尿频、尿急症状，1例切口裂开，1例粘连性肠梗阻，无漏尿、继发性出血等严重并发症。远期[（51±24．2）个月]随访：尿量176～420（273．7±49）mL，最大尿流率11．3～21．5（17±2．2）mL／s，1例日间轻微压力性尿失禁，3例夜间轻度漏尿，2例出现单侧输尿管扩张，肾功能及电解质正常。【结论】去带乙状结肠原位新膀胱术简化了手术操作，且手术安全、可行，可获得满意的容量和控尿排尿效果。[Objective] To explore the feasibly and efficacy of radical cystectomy and orthotopic neobladder substitution with taenia myectomy sigmoid. [Methods] Clinical data and follow up results of 31 patients with bladder carcinoma undergoing radical cystectomy and orthotopic neobladder substitution with taenia myectomy sigmoid were analyzed retrospectively. [Results] Among 31 patients, no death occurred during peroperative period. Symptoms such as frequent and urgent micturition appeared in 15 patients at the early stage after the operation. Disruption of wound occurred in 1 patient, and adhesive intestinal obstruction was found in 1 pa tient. No severe complication such as urinary leakage and secondary hemorrhage occurred. During long term follow up（51±24.2 months）, urinary volume was 176~420（273.7±49）mL and the maximum flow rate was 11.3 - 21.5 （ 17 ± 2.2） mL/s. One patient had slight daytime incontinence, and 3 patients had nocturnal incon tinence, and 2 patients had unilateral ureteral dilation. Renal function and serum electrolytes were normal. [Conclusion] Orthotopic neobladder substitution with taenia myectomy sigmoid is simple, safe and feasible, and may achieve satisfactory volume, urinary control and urination efficacy. E

关 键 词：膀胱切除术 结肠 乙状 外科学 

分 类 号：R694[医药卫生—泌尿科学]